NPI | 1043328651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-0001022) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003410-L) |
Enumeration Date | 2006-08-25 |
Last Update Date | 2021-09-02 |